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Embracing Imperfection: A Healthier Approach to Managing Type 1 Diabetes

Living with Type 1 diabetes (T1D) can be challenging, especially for children, their caretakers, and adults who may feel the pressure to achieve perfect control over their blood sugar level.  As you know T1D is a lifelong condition that requires almost constant attention.  It is the part-time job that you didn’t apply for, you don’t want and you can’t quit.  And there is no paycheck at the end of the week.  You can’t help what genes you inherited in this life and it is not your fault that you got diabetes but once you have it, it is 100% your (or your caregiver’s) responsibility.  But aiming for perfection in controlling diabetes is both unrealistic and potentially harmful.

child checking blood sugar

The goal of diabetes management is to maintain blood sugar levels within a worldwide recognized target range which must be individuated for each person based on their age, mental ability, living situation, finances and how much support they have.

For those of us who have had diabetes and worked in the diabetes education world for a long time have seen many changes to the targets, approaches, and therapies for diabetes.  In the most recent years, almost everything in our lives have been affected by the internet and social media.  While our friend “Doctor Google” is a helpful tool, searching the internet for all the sources of information on diabetes can be overwhelming, confusing and counterproductive.

We know that complications can occur from uncontrolled high and low blood glucose, high blood pressure and high blood fats (cholesterol and triglycerides). However, we know it takes years of these uncontrolled situations to cause problems. But the pendulum seems to have swung to a different side where attaining non-diabetes targets are creating a hyper-vigilance amongst some families and can result in feelings of guilt, frustration, failure and create a cycle of stress that can further complicate diabetes management and life balance.

While good control is a goal we all strive for, it is crucial for patients, caregivers and healthcare professionals to shift the focus from attaining near-perfect levels to striving for a more realistic and sustainable approach.  Embracing imperfection does not mean that you are in denial or lazy, it involves a realistic understanding that variation in blood sugar levels are a natural part of life with diabetes and we use them as “hindsight” to learn our patterns, adjust and try again.

The Risks of Unrealistic Expectations of Managing Type 1 Diabetes

  1. Hypoglycemia: Overzealous control can increase the risk of hypoglycemia, which is dangerous and can lead to seizures or loss of consciousness.
  2. Psychological Stress: Perfectionism often leads to heightened stress levels and the body’s response to stress can cause fluctuations in glucose levels which are hard to measure and adjust insulin for. Stress management is part of diabetes management.
  3. Impact on Quality of Life: Constant worry about maintaining perfect blood sugar levels can reduce the quality of life and may lead to avoidance of normal activities. “Making friends” with a flexible approach to diabetes allows for it to fit into your life instead of fitting your life into diabetes.

Setting Realistic Goals

  1. Individualized Targets: Blood sugar targets should be personalized, taking into account individual health, lifestyle, and risk factors.
  2. Flexibility is Key: Accepting fluctuations in blood sugar levels as a normal part of life with diabetes is crucial. Flexibility in management strategies is more sustainable in the long term.
  3. Education and Support: Being a “life-long learner” is important as well as self-compassion and resilience with a focus on overall well-being as opposed to strict diabetes management.  Seeking emotional support is vital. Support groups and therapy can be beneficial.
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